Health Insurance

With the huge amount of health insurance terminology that is present in our society, it is almost no wonder that so many Americans are left confused by their insurance policies as the economy goes up and down in this country.

Different legislation is passed regarding healthcare nearly every year, and working Americans are having to pay more and more for the coverage that they need. In order to be a responsible citizen and consumer, learning more about this complex field can be a tremendous help. While HMO insurance and other such healthcare plans can seem rather unique and complex, all health insurance policies in America are related in basic ways. Learning and memorizing the differences between these plans can mean getting the health coverage that you need for a much lower price than you are paying now.

It can be a difficult decision to choose between all of the different health policies that are on the market, but getting this concrete help will allow you to learn about the policy that best aligns with your lifestyle, medical history and household income. Additionally, learning more about healthcare will allow you to go into the process confidently, and not be scared away by the sometimes complicated terms and financial figures.

Understanding Health Insurance Terms

Learning all of the healthcare terms that you will hear from your eventual insurance provider is a great way to prepare for buying a health insurance policy. After all, if you understand the key terms associated with your health insurance, you will be more readily able to make smart financial and health-based decisions in the future. While many of the words used by healthcare providers might not mean as much to you now, healthcare is a rapidly changing field. You may need a different policy later on than the one that you have now, so learning about the specifics of this field could help you in the future.

There are hundreds of different health insurance terms that could benefit you, but understanding the most basic and commonly-used words can be a good start. Some of these popular terms include:

  • Premiums – monthly price that you must pay in order to continue receiving health insurance coverage
  • Deductibles – limits that you must pay in healthcare costs every quarter before your insurer can begin paying for the rest of your health bills
  • Copays – small costs that you must pay to your doctor’s office, specialist or hospital whenever you use their services

Comprehending these and many other related terms will help you to be more aware of what you are paying for healthcare, and why.

Family Health Insurance Plans

Looking at family health insurance plans is an important thing to do for millions of Americans, as they are some of the most basic and common health plans available. There are also individual health insurance plans, as outlined below, but family plans are designed to provide the same amount of coverage to a group of two or more people. Before diving into the more niche and specific health policies that you may purchase, understanding these broad plans will help you to get the right coverage for your family.

Family medical insurance is a broad topic that can provide health coverage to you, your spouse and any children that you have who are younger than 26 years of age. As with other health insurance policies, specific health insurance companies, who work with a network of health care providers in order to pay for a number of your health costs, provide these plans.

You will need to pay monthly premiums to keep this coverage, as well as meet a higher-than-average deductible in order to account for the amount of people that are being insured. You will also need to pay certain copays and coinsurance, based on where you are getting your healthcare. However, these plans can be an economical way for big families to stay covered by healthcare, and not worry about individual plans.

HMO & PPO Health Coverages

Next, you should consider the two most popular healthcare coverages. A Health Maintenance Organization (HMO) is a type of health insurance policy that prioritizes affordability, making it one of the most common forms of health insurance in America. This policy allows you to choose a primary care physician that is within your healthcare network, and utilize them to monitor your basic health or refer you to an in-network specialist. These policies do not provide a lot of wiggle room for choosing your own doctor or seeing specialists whenever you want, so they make up for this by providing one of the lowest monthly premiums that you can find, and usually no deductibles to meet.

Related Article: HMO Insurance

In contrast, a Preferred Provider Organization (PPO) is a health insurance policy that puts more of a focus on healthcare service flexibility. While these plans often have much higher monthly premiums and deductibles that you will have to pay, they also allow you to visit any out-of-network health facility in America without needing a referral, or even a primary care physician in the first place. While out-of-network facilities may charge a slightly larger copay and coinsurance to use than in-network services, this type of health insurance is great for those who would like more healthcare options at a slightly higher monthly expense.

EPO, POS & HDHP Health Insurance Coverages

Then, there are the more specific forms of health insurance that are often some kind of a combination of the previous two policies. The Exclusive Provider Organization (EPO) policy is the first of these additional healthcare plans that needs to be considered. This plan allows for slightly higher monthly premiums than an HMO, while also having slightly less room for flexibility than a PPO. An EPO will require you to have a primary care physician, and to stick to the network that your health insurance provider is in. However, you can also use this plan to visit any specialist that is within your network without needing a referral. In this way, an EPO combines two separate features from the top two insurance types.

Next, you can purchase a Point of Service plan (POS) if you are looking for an insurance policy with a slightly different mix of HMO and PPO components. In fact, a POS might be considered an off-shoot policy of an EPO. When you purchase a POS, you will also be required to have a primary care physician, and to get a referral from them whenever you want to see a specialist or another doctor. But a POS will also allow you to visit any healthcare service across the country, regardless of network. Thus, these policies can be cheap when visiting in-network services, but more expensive when visiting out-of-network services.

Finally, a High Deductible Health Plan (HDHP) may be appropriate for those who are willing to sacrifice having a high deductible for a low monthly premium. These policies have the freedom of a PPO, in that they are not restrictive of the network that you can use your insurance on, as well as the inexpensive monthly fees of an HMO. However, for each quarter that you use your health insurance, you will be required to pay a much higher deductible entirely out-of-pocket. There are some tools that you can use to lower these costs, such as opening up a health savings account, but this insurance policy is usually best for those who do not use healthcare services too often due to the very high cost of their deductibles.

Related Article: Saving on Health Care Costs

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